Depression

Depression is a medical illness that involves the mind and body. Also called major depression, major depressive disorder and clinical depression, it affects how you feel, think and behave. Depression can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness, nor is it something that you can simply "snap out" of. Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or other treatment.

Depression symptoms include:

• Feelings of sadness or unhappiness
• Irritability or frustration, even over small matters
• Loss of interest or pleasure in normal activities
• Reduced sex drive
• Insomnia or excessive sleeping
• Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
• Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
• Slowed thinking, speaking or body movements
• Indecisiveness, distractibility and decreased concentration
• Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
• Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren't going right
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent thoughts of death, dying or suicide
• Crying spells for no apparent reason
• Unexplained physical problems, such as back pain or headaches

It's not known exactly what causes depression. As with many mental illnesses, it appears a variety of factors may be involved. These include:

• Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
• Neurotransmitters. These naturally occurring brain chemicals linked to mood are thought to play a direct role in depression.
• Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result from thyroid problems, menopause and a number of other conditions.
• Inherited traits. Depression is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing depression.
• Life events. Events such as the death or loss of a loved one, financial problems and high stress can trigger depression in some people.
• Early childhood trauma. Traumatic events during childhood, such as abuse or loss of a parent, may cause permanent changes in the brain that make you more susceptible to depression.

Numerous depression treatments are available. Medications and psychological counseling (psychotherapy) are very effective for most people.

In some cases, a primary care doctor can prescribe medications to relieve depression symptoms. However, many people need to see a doctor who specializes in diagnosing and treating mental health conditions (psychiatrist). Many people with depression also benefit from seeing a psychologist or other mental health counselor. Usually the most effective treatment for depression is a combination of medication and psychotherapy.

If you have severe depression, a doctor, loved one or guardian may need to guide your care until you're well enough to participate in decision making. You may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.